Patient and clinician perspectives on shared decision-making in infertility treatment: A qualitative study.

OBJECTIVES: To explore the considerations and barriers to implementing shared decision-making (SDM) in infertility treatment among female infertility patients, their male spouses, and fertility clinicians. METHODS: Participants were recruited from a reproductive medicine hospital in China's Shandong Province using purposive sampling. One-on-one interviews were held with female infertility patients and their spouses. In addition, a focus group discussion was conducted with fertility clinicians. Data analysis was subjected to open, axial, and selective coding. RESULTS: Nineteen female infertility patients and 10 male spouses were interviewed one-on-one. Five clinicians participated in the focus group discussion. Most female patients wanted to participate in the decision-making process, and that spouses and fertility clinicians supported SDM. Furthermore, key barriers were identified from the perspectives of multiple stakeholders, including communication difficulties, psychological pressure on female patients, patient preferences, multiple treatment stages, male spousal participation, clinician-patient trust, and subjective patient factors. CONCLUSIONS/PRACTICE IMPLICATIONS: This study explored the considerations of and barriers to implementing SDM in infertility treatment. Key barriers were identified from the perspectives of multiple stakeholders. Based on the findings, clinicians should encourage patients and their spouses to actively participate in decision-making, and provide objective and realistic guidance.

Alcoholysis kinetics and mechanism studies of ethyl levulinate production from ball milled corn stover.

Alcoholysis of ball-milled biomass over catalysts with Brønsted and Lewis acid sites provides an efficient and sustainable scheme to produce versatile biobased chemicals under mild conditions; however, optimizing the process parameters is challenged by the complexity of reaction pathways and the multiplicity of ball milling and combination catalyst gains. To address these challenges, we present kinetic analysis of ethyl levulinate (EL) production from ball-milled corn stover catalyzed by Brønsted (B) acidic ionic liquid [Bmim-SO3H][HSO4] (SO3H-IL) and Lewis (L) acidic Al2(SO4)3. Product analysis shows that cellulosic substrates can form EL either through the intermediate ethyl-d-glycopyranoside (EDGP) or levoglucosenone (LGO), with the former leading the alcoholysis reaction. Kinetics results reveal that ball milling accelerates the reaction rate by promoting the formation of EDGP and LGO from cellulose. Pure SO3H-IL gives high selectivity towards EDGP from ball-milled corn stover and promotes the LGO production, whereas addition of Al2(SO4)3 substantially facilitates their further conversion to EL. Our findings contribute to the rational design of efficient catalytic strategies for sustainable and profitable biorefinery.

A comprehensive assessment on bioavailability, leaching characteristics and potential risk of polycyclic aromatic hydrocarbons in biochars produced by a continuous pyrolysis system.

Biochar application as a soil amendment has attracted worldwide attention. Nevertheless, polycyclic aromatic hydrocarbons (PAHs) formed during biochar production might enter into ecosystems and threaten human health after application to soil. Continuous pyrolysis systems tend to cause an accumulation of PAHs in biochar owing to short residence time and rapid cooling. This study conducted a comprehensive assessment regarding potential risk of PAHs in biochars produced by a continuous pyrolysis system based on bioavailability, leaching behavior, toxic equivalent quantity, health risk and phytotoxicity of PAHs. Results showed that the concentrations of total PAHs in biochars were in the range of 93.40-172.40 mg/kg, exceeding the European Biochar Certificate standard. 3-rings PAHs were the predominant groups. The percentages of total freely dissolved and leachable PAHs were lower than 1%. RH contained the least bioavailable and leachable PAHs concentration and phytotoxicity compared with CS and PS, which might attribute to the characteristic of three biochars. CS and PS were acidic and exhibited high levels of DOC and VFAs, while RH was strongly alkaline and presented greater aromaticity and higher surface area, which might have resulted in high adsorptive capacity and decreased bioavailability of PAHs. When the biochar application rate was higher than 0.6 t/ha, the incremental lifetime cancer risk value for human exposure to biochar-borne PAHs through the biochar-amended soil was over 10-6, suggesting carcinogenic risks. Germination index values of biochars ranged from 25.66 to 88.95%. Phytotoxicity mainly was caused by bioavailable PAHs and dissolved organic compounds. Overall, these findings highlighted that although the percentage of bioavailable PAHs was low, the potential health risk and phytotoxicity of PAHs in biochars produced by a continuous pyrolysis system was of a great concern. High biochar application rates should be avoided without processing both for soil safety and human health.

A pilot-scale biomass pyrolytic poly-generation plant performance study and self-sufficiency assessment.

This work studied the influence of pyrolysis temperature on the energy and mass balance of pyrolysis of rice husk (RH), cotton stalk (CS) and fruit branch (FB) in a pilot-scale biomass pyrolytic poly-generation plant. The paper presents energy balance and self-sufficiency assessment of pilot-scale pyrolysis plant processing different types of biomass. The results also include characterization of the pyrolysis products. The volatile matter varied from 6.5 to 25.8% at different temperatures for the three feed stocks, which can be used as indexes for the degree of carbonization of biochar. The yield of pyrolysis gases enriched with H2, CH4 and other alkanes, and olefins increased significantly with increasing pyrolysis temperature from 550 to 650 °C. With a lower heating value >17.1 MJ/m3, an energy self-sufficient system is possible using only the pyrolysis gas. Biomass pyrolytic poly-generation technology offers a promising means of converting abundant agricultural residues into energy and added-value products.

Exosomal miRNA Profiling to Identify Nanoparticle Phagocytic Mechanisms.

Inhaling a dangerous amount of nanoparticles leads to pulmonary inflammatory and immune disorders, which integrates several kinds of cells. Exosomes are suggested to play a crucial role in intercellular communication via miRNA transmission. To investigate the role of exosomal miRNA in nanoparticle phagocytosis, a total of 54 pneumoconiosis patients along with 100 healthy controls are recruited, exosomes derived from their venous blood are collected, and then exosomal miRNAs are profiled with high-throughput sequencing technology. miRNAs which are differentially expressed are used to predict target genes and conduct functional annotation. Interactions between miRNA hsa-let-7a-5p, hsa-let-7i-5p, and their cotarget gene WASL are found that can affect nanoparticle phagocytosis. The follow-up analysis of gene structure, tissue specificity, and miRNA-target gene regulatory mode supports the findings. Specially, the assumption is further confirmed via a series of cellular experiments, and the fibroblast transdifferentiate rate that is used as an indicator of nanoparticle phagocytosis decreased when elevating miRNA expression level. Thus, data in this study indicate that downregulation of miRNA hsa-let-7a-5p and hsa-let-7i-5p contributes to WASL elevation, promoting WASL and VASP complex formation, which is necessary for initiating Arp2/3 induced phagocytosis.